From the Guidelines
After the initial doses of artesunate at 0,12, and 24 hours, the once daily dose should be started at 48 hours (day 3). This means patients receive doses at 0,12,24, and then 48 hours, followed by once daily dosing thereafter until the full treatment course is completed. The initial more frequent dosing schedule (0,12,24 hours) is designed to rapidly reduce the parasite burden in the bloodstream, which is critical in severe malaria cases. This loading dose approach achieves therapeutic drug concentrations quickly. The transition to once daily dosing at 48 hours maintains adequate drug levels while the parasite load has been substantially reduced. The complete treatment course with artesunate typically lasts 3-7 days depending on clinical response and local treatment guidelines, as recommended by recent studies 1. It's essential to follow artesunate with a complete course of another antimalarial agent to prevent recrudescence and ensure complete parasite clearance.
Some key points to consider in the treatment of malaria include:
- The use of intravenous artesunate as a first-line treatment for severe malaria, as recommended by WHO 1
- The importance of transitioning to oral treatment once the patient is clinically improved and able to take oral medication
- The need for careful management of clinical complications, such as acute kidney injury and concomitant bacterial infections
- The use of restrictive fluid management to avoid pulmonary or cerebral oedema
Overall, the treatment of malaria requires careful consideration of the patient's clinical condition, the severity of the disease, and the potential for complications. By following established treatment guidelines and using effective antimalarial agents, healthcare providers can help to improve outcomes and reduce the risk of morbidity and mortality associated with malaria.
From the Research
Dosing Schedule for Artesunate
- The initial doses of artesunate are given at 0,12, and 24 hours.
- According to the study 2, after the initial doses, artesunate is given daily.
- This means that the once daily dose should be started after the third dose at 24 hours, which would be at 48 hours (or 24 hours after the third dose).
- The daily dosing schedule is also supported by study 3, which states that artesunate was given at 12 hours, then 24 hours, then daily.
Timing of Once Daily Dose
- Based on the studies, it appears that the once daily dose of artesunate should be started 24 hours after the third dose, which is given at 24 hours.
- This would result in a dosing schedule of 0,12,24,48,72 hours, and so on.
- It is essential to note that the specific dosing schedule may vary depending on the individual patient and the clinical setting, and should be determined by a healthcare professional.